Make a name on the Web
 

Thank you for your interest in the IWI Partner Program. Application is free! To receive your Partner ID, simply fill out the following form. You should receive a partner ID via email within a day. Make sure you save the email. It contains the ID number and password you'll need to enter during the online ordering process to make sure you get credit for each server you purchase.
 
  Please complete all the fields that are marked in bold text
   
 
Partners Program Application Form
 

 Your Choice of a Partner ID

 
  Your password will be sent to you by email upon successful application.
 Company Name   *
 Registration No.   *
 Co. Address   *
   
 City / State  
 Postal Code   *
 Country  
   
 Authorised Personnel
 Name   *
 I/C No.
  *
 (This will be used to verify yourself for any technical or sales  assistance)
 DOB (dd/mm/yyyy)
  *
 (This will be used to verify yourself for any technical or sales  assistance)
 Designation   *
 Office Tel No.   *
 Office Fax No.   *
 Mobile No.  
 Email Address   *
 
 Billing Personnel (if different from above)
 Name  
 Designation  
 Office Tel No  
 Office Fax No  
 Mobile No  
 Email Address  
 
 Other Information
 
 Core Business Focus  
  Are you reselling for anyone else? Yes No
 
 If yes, state who  
 Expected Sales Volume  
 Are you an existing customer of IWI? Yes No
 
 If yes, provide domains:  
   
    
     
 
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